100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
Summary SEXUAL HEALTH MLA MAPPING - for Medical Exams and Finals £6.47
Add to cart
Quickly navigate to
Preview
  2.  
  3. The University Of Manchester (UOM)
  4.  
  5. Medicine (MLA)

Summary

Summary SEXUAL HEALTH MLA MAPPING - for Medical Exams and Finals
 0 purchase

One page summaries for topics listed in the MLA Topic Map associated with sexual health Contents include: Contraception; Pelvic Inflammatory Disease; Dyspareunia; HIV; etc. All MLA topics are covered within my shop - see other documents for more Each topic covers approx. one page for a succinct ...

[Show more]

Preview 3 out of 17  pages

Document information

  • July 8, 2024
  • 17
  • 2023/2024
  • Summary

Subjects

Written for

All documents for this subject (38)

Seller

avatar-seller
EtheMedic

Content preview

Contraception Advice/Request
Definition & DDx
Hormonal Contraception Emergency Hormonal Contraception
- Combined - Ulipristal (EllaOne)
o Pill e.g., Rigevidon, - Levonorgestrel (Levonelle)
Microgynon
o Patch e.g., Evra Non-hormonal Contraception
o Ring e.g., Nuvaring - Copper IUD (Can be emergency)
- Progestogen only - Barrier methods e.g., M/F condom,
o Pill e.g., Desogestrel, diaphragm/cervical cap
Cerelle, Cerazette - Surgical methods, e.g., tubal
o Subdermal implant e.g., ligation, vasectomy
Nexplanon - Lactational amenorrhoea
o Injection e.g., Depo - Fertility awareness methods
o Intrauterine system e.g.,
Mirena, Levosert

Combined Contraception
Anatomy & Risks
Combined Hormonal Contraception (CHC)
- Contains both oestrogen and progestogen
- Thickens cervical mucous to obstruct sperm entry
- Thins lining of endometrium / inhibits ovulation
- Most common = every-day pills
o 21 hormone pills, 7 hormone free pills
o Can do ‘tricycling’ with 9 weeks hormones and 7-day hormone free interval
o OR, continuous without HFI / used until bleeding occurs, then 4-day HFI
- Other types = each pill same hormone dose (monophasic); phasic (pills with different
amounts, must be taken in same order)

Contraindications of CHC
UKMEC4 (Absolute CI) UKMEC2 (Adv. outweigh disadv.) - CVD
- Known/suspected pregnancy - Initiating after Hx MI/stroke
- ≥35yo smoking ≥15/day - ≤3wks postpartum + VTE risk
- Obesity factors
- Breastfeeding ≤6wks postpartum - Cardiomyopathy/AF
- FHx VTE ≤45yo - BMI 30-34
- Breast cancer/hx recent cancer - BP ≥160sys/≥100dias
- BRCA genes - Vascular disease
UKMEC3 (Disadv. outweigh the adv.) - IHD
- Breastfeeding >6wks postpartum - Hx cerebrovascular accident/TIA
- Hx VTE/Heart disease/stroke - Hx VTE
- BMI ≥35 - Complex valve disease
- Migraines with aura - Antiphospholipid antibodies/
- Liver/gallbladder disease thrombogenic mutations
UKMEC1 = no limit on that choice of - Surgery with prolonged
contraception immobilisation

,Treatment/Management & Side effects
When to start combined: Missed pill during:
- 1st day natural period = pregnancy - Wk1: use emergency if UPSI
protection immediately - Wk2: no emergency
- Any other day = need to use other - Wk3: Take last pill missed, finish
precautions for 7 days current pack, skip pill-free period
- Postpartum = can start 21 days Side effects of combined:
after birth if not breastfeeding - Breast tenderness and
If vomiting within 3hrs taking = take enlargement
another one - Headaches
- May be breakthrough bleed similar - Mood and libido changes
to period during HFI - N&V
o Absence of this doesn’t - Irregular menstrual
indicate pregnancy bleeding/spotting/amenorrhoea
Pt with gastric sleeve/bypass/duodenal - Ovarian cysts
switch cannot have oral contraception - VTE

Copper IUD
- Recommended for women ≥40 – Unexpected bleeding/pain:
can stay in place until menopause - Displacement/expulsion of IUD
(~10yrs) - Uterine perforation
- Not recommended ≤28days - PID
postpartum - Pregnancy (including ectopic)
- Follow up 3-4wks after insertion
o Confirm no pregnancy Contraindications
o Discuss future - Postpartum/post-abortion sepsis
contraception - Cervical/endometrial cancer
o Establish if IUD for long - Chlamydia/gonorrhoea/cervicitis
term - PID/pelvic TB
- Regularly check position of device - Unexplained vaginal bleeding
- Can experience spotting/period-
like pains after insertion

Progesterone Only
- Reduced FSH to prevent follicular development in ovaries
- Inhibits LH surge
- Thickens cervical mucous
- Thins endometrium lining

Contraceptive Implant
- Works for 3yrs – most effective form
- No daily medication regimen (takes 7 days to work if not inserted on day 1)
- Periods can stop/become irregular/last longer – COCP given to manage these
- Acne may occur/worsen
- LA should be used to fit the device
- Can be tenderness, bruising and swelling at site of insertion
- CI: IHD; breast cancer; CVD; liver cirrhosis/cancer; unexplained vaginal bleeding

, IUS
- Works for 5yrs Can be used by smokers/
- Periods become lighter breastfeeding/etc.
- SE: irregular bleeding/spotting in
first 6mths Injection/Depo
- Small infection risk during first - Given every 13wks
20days - Can be associated weight gain
- If pt ≥40 – can stay in place until - Only contraceptive where it may
menopause take time to regain fertility (6-
- Useful for women with 12mths)
heavy/painful periods

SE: Postpartum
- Breast tenderness/enlargement - Contraception not required first
- Headache 3wks postpartum
- Changes to mood/libido - IUD/IUS can be inserted
- N&V immediately after delivery up to
- Irregular menstrual bleeding, 48hrs
spotting, amenorrhoea o If >48hrs, then need to wait
- Ovarian cysts 28 days
- Progestogen only = any time
Epilepsy: recommended IUD/IUS/depo

Emergency Contraception
Copper IUD
- Gold standard
- Up to 120hrs UPSI/within 120hrs earliest expected date of ovulation
- Anti-implantation effect if fertilisation occurs
Ulipristal
- Suppressing LH surge
- Delays ovulation for ≥5 days (until sperm from UPSI no longer viable)
- Can be used within 120hrs of UPSI
- Wait 5 days before starting ongoing hormonal contraception
- Only used once per cycle
- CI: severe asthma on oral steroids; severe liver disease
- Avoid breast feeding ≥1wk after taking
- SE: headache, nausea, dysmenorrhoea
- Repeat dose if vomiting within 3hrs taking
Levonorgestrel
- Within 72hrs UPSI
- Delays ovulation for ≥5 days (until sperm from UPSI no longer viable)
- Thickens cervical mucous
- Ineffective after LH surge
- Can take more than once in same cycle
- Can ‘kick start’ hormonal contraception
- Can be less effective in BMI≥26/≥70kg
o Unlicensed ‘double dose’ may be used

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller EtheMedic. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for £6.47. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

65539 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy revision notes and other study material for 15 years now

Start selling

Recently viewed by you

Summary ·

(0)

Samenvatting BDTV
£6.47
  • (0)
Add to cart
Added